[A woman with hyperpigmentation and dark urine]

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Targeted therapy with BRAF and MEK inhibitors is a standard treatment for BRAF-mutated melanoma.
• Melanoma treatment can lead to various side effects, including skin changes.

Observation:

• A 54-year-old patient presented with fever after initiating BRAF and MEK inhibitor therapy for advanced melanoma.
• Incidental findings included diffuse skin hyperpigmentation and dark urine.

Findings:

• The observed skin changes were consistent with diffuse cutaneous melanosis, a rare complication.
• This condition is attributed to the systemic release of melanin or its precursors.
• Diffuse cutaneous melanosis is typically associated with a poor prognosis in advanced melanoma.

Implications:

• This case highlights a rare side effect of BRAF and MEK inhibitors in melanoma patients.
• Despite the ominous prognostic implications of diffuse cutaneous melanosis, the patient demonstrated a positive response to targeted therapy.
• Further research may elucidate the precise mechanisms and prognostic significance of this complication in the context of modern melanoma treatments.